The UARTO Study was funded by U.S. National Institutes of Health (NIH) R01MH054907, P30AI27763, and K23MH079713. The authors also acknowledge the following additional sources of support: NIH T32AI007433 (Chan), K23MH099916 (Siedner), K23MH087228 (Haberer), U01CA066529 (Martin), P30AI060354 (Mayer), K24MH087227 (Bangsberg), K23MH096620 (Tsai), David Brudnoy Scholar Award (Chan), and the Burke Family Foundation (Weiser). Dr. Mayer has also received unrestricted research grants from Merck, Gilead, and Bristol Meyers Squibb.
AIDS (Disease) -- Uganda -- Effect of availability of anti-retroviral drugs on, AIDS (Disease) -- Patients -- Stigma (Social psychology), AIDS (Disease) -- Patients -- Treatment
Objective—Program implementers have argued that the increasing availability of anti-retroviral therapy (ART) will reduce the stigma of HIV. We analyzed data from Uganda to assess how HIV-related stigma has changed during a period of ART expansion.
Design—Serial cross-sectional surveys.
Methods—We analyzed data from the Uganda AIDS Rural Treatment Outcomes (UARTO) study during 2007-2012 to estimate trends in internalized stigma among people living with HIV (PLHIV) at the time of treatment initiation. We analyzed data from the Uganda Demographic and Health Surveys (DHS) from 2006 and 2011 to estimate trends in stigmatizing attitudes and anticipated stigma in the general population. We fitted regression models adjusted for socio-demographic characteristics, with year of data collection as the primary explanatory variable.
Results—We estimated an upward trend in internalized stigma among PLHIV presenting for treatment initiation (adjusted b=0.18; 95% CI, 0.06 to 0.30). In the general population, the odds of reporting anticipated stigma were greater in 2011 compared to 2006 (adjusted OR=1.80; 95% CI, 1.51 to 2.13), despite an apparent decline in stigmatizing attitudes (adjusted OR=0.62; 95% CI, 0.52 to 0.74).
Conclusions—Internalized stigma has increased over time among PLHIV in the setting of worsening anticipated stigma in the general population. Further study is needed to better understand the reasons for increasing HIV-related stigma in Uganda and its impact on HIV prevention efforts.
Lippincott, Williams & Wilkins
51. Chan BT, Weiser SD, Boum Y, Siedner MJ, Mocello AR, Haberer JE, Hunt PW, Martin JN, Mayer KH, Bangsberg DR, Tsai AC. Persistent HIV-related stigma in rural Uganda during a period of increasing HIV incidence despite treatment expansion. AIDS. 2014 Sep 27.